title: Prevalence and outcomes of anatomic lung resection for hemoptysis: an analysis of the nationwide inpatient sample database.
abstract: BACKGROUND
  Pulmonary resection for hemoptysis carries an increased risk of death. However, the extent and predictors of risk are poorly characterized and based on institutional case series. We analyzed the Nationwide Inpatient Sample (NIS) database to determine the outcome of patients undergoing anatomic pulmonary resection who were admitted with a diagnosis of hemoptysis.
  
  
  METHODS
  We queried the NIS for hospitalized patients who were admitted emergently or urgently with hemoptysis as the principal diagnosis or as a secondary or tertiary diagnosis. We examined the outcomes of those patients who underwent lobectomy or pneumonectomy. Logistic regression analysis was used to determine clinical characteristics that were independent risk factors for death.
  
  
  RESULTS
  During a 10-year period, 457,523 admissions for the diagnosis of hemoptysis were identified, and 2,671 patients (0.58%) underwent resection, comprising lobectomy in 2,205 and pneumonectomy in 466. The median age was 58 years, and 1,682 (63%) were men. Compared with those patients resected without a diagnosis of hemoptysis, those admitted with a hemoptysis diagnosis had a higher mortality rate after pneumonectomy (15.2% vs 9.7 %, p = 0.320) and lobectomy (6.6% vs 3.0%, p = 0.006). Advanced age, associated bacterial infections, the presence of a lung abscess/necrosis, extent of resection, and associated diagnoses of sarcoidosis and renal failure were multivariable independent risk factors for death.
  
  
  CONCLUSIONS
  Analysis of this national database with its inherent limitations demonstrates that major lung resection can be performed in the setting of hemoptysis with reasonable mortality rate. Advanced age, extent of resection, systemic illnesses such as renal failure, sarcoidosis, and the presence of a lung abscess are independent predictors of death.
authors.affiliation: Division of Thoracic Surgery, Department of Cardiothoracic Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York 10065, USA. pas2022@med.cornell.edu
authors.forename: Subroto
authors.initials: S
authors.lastname: Paul
authors.forename: Weston
authors.initials: W
authors.lastname: Andrews
authors.forename: Abu
authors.initials: A
authors.lastname: Nasar
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Port
authors.forename: Paul C
authors.initials: PC
authors.lastname: Lee
authors.forename: Brendon M
authors.initials: BM
authors.lastname: Stiles
authors.forename: Art
authors.initials: A
authors.lastname: Sedrakyan
authors.forename: Nasser K
authors.initials: NK
authors.lastname: Altorki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006469:Hemoptysis / Q000150:complications / Q000601:surgery*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: 11